Hypothyroidism
What is the best time of day for the nurse to administer levothyroxine to a patient with hypothyroidism?
A. With Meals
B. At bedtime
C. In the morning with food
D. In the morning on an empty stomach
D. In the morning on an empty stomach
The nurse is reviewing labs for a patient with Cushing’s syndrome. Which electrolyte imbalance is most common?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
A nurse is caring for a patient with hypoparathyroidism. Which electrolyte imbalance should be closely monitored?
A. Hypercalcemia
B. Hypocalcemia
C. Hyperkalemia
D. Hyponatremia
B. Hypocalcemia
A patient presents with severe hypertension, headache, and palpitations. These symptoms are classic for which endocrine disorder?
A. Hyperthyroidism
B. Addison's disease
C. Pheochromocytoma
D. Cushing's syndrome
C. Pheochromocytoma
Addison’s disease is characterized by a deficiency in which adrenal hormone?
A. Insulin
B. Thyroxine
C. Cortisol
D. Epinephrine
C. Cortisol
A nurse is assessing a patient with untreated hypothyroidism. Which clinical finding is most expected?
A. Tachycardia
B. Bradycardia
C. Hyperreflexia
D. Weight loss
B. Bradycardia
A patient presents with central obesity, moon face, and purple striae. Which condition do these signs indicate?
A. Addison's Disease
B. Grave's Disease
C. Cushing's Syndrome
D. Hashimoto's thyroiditis
C. Cushing's Syndrome
The nurse gently taps on a patient’s cheek and observes facial twitching. What is this sign and what does it indicate?
A. Chvostek's sign; hypocalcemia
B. Trousseau's sign; hypercalcemia
C. Babinski reflex; hypokalemia
D. Murphy's sign; hypernatremia
A. Chvostek's sign; hypocalcemia
When assessing a patient with suspected pheochromocytoma, what action should the nurse avoid and why?
A. Palpating the abdomen due to catecholemine release
B. Taking vital signs due to tachycardia
C. Drawing blood for glucose due to anemia
D. Monitoring urine output due to dehydration
Which skin change would the nurse expect in a patient with Addison’s disease?
A. Pale skin
B. Vitiligo
C. Cyanosis
D. Hyperpigmentation
Which laboratory values would confirm a diagnosis of primary hypothyroidism?
A. Low TSH, high T4
B. Elevated TSH, low T4
C. High TSH, high T4
D. Low TSH, low T4
A patient with Cushing’s syndrome is prescribed corticosteroids. What priority education should the nurse provide?
A. Take medication with dairy
B. Avoid protein-rich meals
C. Do not stop corticosteroids abruptly
D. Take only during illness
A patient postoperative thyroidectomy shows a positive Trousseau’s sign. What is the priority nursing intervention?
A. Encourage ambulation
B. Administer potassium
C. Administer IV calcium gluconate
D. Increase vitamin D intake
C. Administer IV calcium gluconate
Which laboratory test is most specific for diagnosing pheochromocytoma?
A. Serum cortisol
B. TSH
C. Plasma free metanephrines
D. 24-hour calcium level
C. Plasma free metanephrines
Which lab results are consistent with Addison’s disease?
A. Hypernatremia and hypokalemia
B. Hyponatremia and hyperkalemia
C. Normal sodium and potssium
D. Hypocalcemia and hypokalemia
B. Hyponatremia and hyperkalemia
A patient reports fatigue, weight gain, and cold intolerance. Which nursing diagnosis is most appropriate?
A. Risk for infection
B. Ineffective airway clearance
C. Activity intolerance
D. Acute pain
C. Activity intolerance-related to decreased metabolic rate
A patient with Cushing’s syndrome has elevated blood glucose and facial rounding. What is the most important nursing intervention?
A. Encourage mobility
B. Monitor blood glucose levels
C. Assess skin turgor
D. Provide low-carb diet
A patient with hypoparathyroidism is at risk for which life-threatening complication?
A. Seizure
B. Stroke
C. Myocardial infarction
D. Laryngospasm
D. Laryngospasm
What medication class is given pre-operatively to stabilize blood pressure in patients with pheochromocytoma?
A. Beta-blockers
B. Alphaadrenergic blockers
C. Diuretics
D. Corticosteroids
B. Alpha-adrenergic blockers
A patient with Addison’s disease reports vomiting and severe fatigue. Blood pressure is 80/50. What is the nurse’s priority action?
A. Start antiemetic therapy
B. Encourage ice chips and oral fluids
C. Administer IV fluids
D. Administer IV hydrocortisone
A patient recently started on levothyroxine reports palpitations and tachycardia. What should the nurse do first?
A. Reassure the patient
B. Continue the medication
C. Hold the next dose and notify the provider
D. Decrease the dose
C. Hold the next does and notify the provider
A patient with Cushing’s syndrome develops sudden mood swings and has signs of infection. What complication should the nurse suspect?
A. Adrenal insufficiency
B. Immunosuppression due to corticosteroids
C. Hyperthyroidism
D. Addisonian Crisis
What diet should the nurse recommend for a patient with hypoparathyroidism?
A. Low calcium, high phosphorus
B. High protein, low fat
C. High calorie, high carbohydrate
D. High calcium, low phosphorus
D. High calcium, low phosphorus
A patient with pheochromocytoma develops a blood pressure reading of 200/120 mmHg and reports a pounding headache. What condition is occurring?
A. Thyroid storm
B. Addisonian Crisis
C. Hypertensive crisis
D. Myxedema coma
C. Hypertensive crisis
What long-term management teaching is essential for a patient with Addison’s disease?
A. Avoid all soidum intake
B. Restrict fluids
C. Wear a medical alert bracelet and carry emergency steroids
D. Discontinue steroids during illness
C. Wear a medical alert bracelet and carry emergency steroids